7 weeks post op and I'm scared sex is going to undo the muscle repair. When did everyone else feel ready?

Bit embarrassed to post this but I've searched the forum and nobody has, so. Full TT with muscle repair on 4th July, 7 weeks tomorrow. Scar is closed and dry, swelling is doing the evening thing, I'm back at work part time. My surgeon signed me off for "normal activity" at my 6 week check and when I asked about sex he said "when you feel ready" and moved on, which I now realise was him being tactful and me being too awkward to push.

The problem is I do not feel ready and I'm not sure I'm ever going to unless someone tells me it's physically safe. Every time we've got close I tense up completely because I'm picturing the stitches inside going. My husband has been lovely and patient but it's been nearly 3 months including the pre op ban and it's starting to feel like an elephant in the room. So: is it actually safe at 7 weeks? Is there stuff to avoid? Does the swelling get worse after? Does the numbness make it weird (mine is numb from the scar up to nearly my belly button)? I feel ridiculous typing all this but I'd rather ask strangers than google it at midnight again.

Not ridiculous at all, I think everyone has this question and nobody asks it. For me it was about week 5, and the first go was very cautious and very short, on my back with a pillow under my knees so my stomach wasn't stretched out flat. Nothing bad happened. The next morning I was a bit puffier than usual, same as after a long day on my feet, gone by lunchtime.

The gym analogy that helped me: if you wouldn't do a plank yet, don't get into any position that's basically a plank. Anything on top or anything where you're holding yourself up on your arms is core work whether you call it that or not. Keep your weight off your abdomen and let the other person do the moving for the first few times.

Gemma W. said:

Does the numbness make it weird

Yes and no. Mine was numb to above the belly button for the best part of a year and the strangest part was the contrast, feeling touch above and below the numb patch and nothing in between. It didn't stop anything, it was just odd, and I got used to it. The thing I'd actually flag from my own experience is the scar: at 7 weeks mine was still tender to pressure, so anything that put weight or friction across the lower tummy I avoided for a good while longer. Positions where nobody was pressing on it were fine.

The tensing up though, that's the real barrier and it's not physical. I told my husband exactly what I was scared of, out loud, and the fear got a lot smaller once it was said.

This is a question patients very often do not ask in clinic and then worry about at home, so I am glad it has been asked here. The general picture: most surgeons are comfortable with sexual activity being resumed gently somewhere around 4 to 6 weeks after an abdominoplasty, and by 7 weeks with a closed, dry wound and a 6 week review behind you, the muscle repair has had the bulk of its early healing time. A rectus plication is a line of permanent or slow-absorbing sutures through the muscle sheath, and by this stage it is protected by scar tissue as well as by the stitches. It is not undone by ordinary movement.

What surgeons do ask people to avoid in this window is the same thing they ask around exercise: sustained loading of the abdominal wall. The site's guidance on that, no core work or heavy lifting for about 6 to 8 weeks, is set out in tummy tuck recovery weeks 3 to 6, and the practical translation is that positions requiring you to hold your own trunk up, brace, or bear weight through your arms and abdomen are core work by another name. Positions where the abdomen is relaxed and unloaded are a different matter. Increased swelling for a day afterwards is expected for the same reason it follows any exertion; a localised, one-sided, persistent swelling, or new pain rather than tightness, would be something to have looked at rather than to wait out. Direct pressure or friction on the scar is worth avoiding while it is still pink and tender, which is often well past 7 weeks.

Altered sensation across the lower abdomen is very common, usually improves over months, and does not by itself change what is safe, though it can be disconcerting; the site covers what tends to recover in numbness after a tummy tuck. I would add one thing: your own surgeon's "when you feel ready" was almost certainly a green light rather than a dodge, but if you want a specific answer, ring the secretary and ask for it. Surgeons field this question routinely, and anyone with a hernia repair, a wound that healed slowly, or a combined procedure may reasonably be given a longer or more specific timeline than the general one I have described.

Update. I rang the secretary like Mr Okafor suggested, expected to die of embarrassment, and got a completely matter of fact "yes, from 6 weeks, just avoid anything strenuous and stop if it hurts." Which is exactly what everyone here said, but hearing it from the clinic switched something off in my head. Pillow under the knees, nothing on top, and it was fine. A bit puffy the next morning, gone by lunch, as Paula said. The tensing up took a couple of goes to go away. Posting this mostly for the next person searching at midnight: it's normal to be scared, ask the actual question, they've heard it a thousand times.